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story.lead_photo.caption For those who are suffering from an egg allergy, it affects many foods beyond the egg itself. Eggs serve several purposes in recipes, but there are several substitutes for eggs that will still produce a satisfying end result. Photo by Charlie Neibergall/AP file photo
Lynn Eaton

It is certainly allergy season in Missouri. Many who have been outside have noticed runny nose, sneezing or itchy eyes due to environmental allergens such as pollen. Most of us can control these symptoms with medications and/or lifestyle changes. For someone with food allergies, avoiding the allergen (the food that causes the allergic reaction) is of vital importance. While this is easier to do now than 20 years ago, there are still significant obstacles to avoiding food allergens, including limited education on what to do for someone with food allergies.

Let's begin by defining food allergies. A food allergy is when a person's immune system forms a response to the consumption of a certain food or food group. The amount consumed does not matter; even a microscopic amount of the offending food can cause a reaction. The severity of the reaction can range from mildly annoying to life-threatening and can include symptoms such as flushing, itchiness, rash, hives, becoming lightheaded, fainting, nausea, vomiting, diarrhea, cramping and swelling. These symptoms may occur in combination with one another, and sometimes reactions are different from one time to the next. The only way to prevent an allergic reaction is to avoid the food completely.

Happily, avoiding food allergens is easier than it used to be, thanks to the Food Allergen Labeling and Consumer Protection Act of 2004. This law requires that the eight most common food allergens (peanuts, tree nuts, wheat, soy, milk, eggs, fish and shellfish) must be clearly labeled in the ingredients list or in a separate "Contains" statement on the food label. This allows people with allergic reactions to clearly find foods that contain any of these ingredients and avoid them. While this helps the person avoid food allergens when shopping for themselves, eating at restaurants or at a friend or relative's house can be difficult or impossible due to limited education about food allergies.

If you are asked to cook for someone with a food allergy, there are a few simple ways to help protect them. First, make sure the recipe used does not contain the food the person is allergic to. When in doubt, ask the person with the food allergy. Next, use the ingredients lists and "Contains" statements on food labels to find ingredients that do not contain the offending allergen. Before beginning to cook, ensure pots, pans, plates, bowls and utensils are cleaned well, preferably in a dishwasher. Everyone helping to cook should be made aware preparation areas and cooking implements are to be used only for the recipe that does not contain the offending allergen(s). For example, a spoon used to stir the allergen-free dish should never be used to stir anything else. If other items are being cooked in the same area, any pots and pans used to cook or prepare the allergen-free dish should be covered tightly when possible. Finally, the serving area for the allergen-free recipe needs to be separate from other dishes. This includes plates and utensils.

Food allergies are different from food intolerances in many ways. Food intolerances occur when foods are not digested and/or absorbed well and they do not involve the immune system. Food intolerances are dose-dependent, so the more of the offending food the person consumes, the worse the symptoms. These symptoms usually only involve the gastrointestinal system and while they can be very unpleasant, they are not often life-threatening.

Personal and professional experience has shown me the rewards of accommodating someone with food allergies. My father has severe allergies to many foods, including some nuts, bananas, coconut and melons. After many years of practice, it is easy for me to make sure he can eat what is cooked at my house. He feels safe eating with me because he knows that I do a good job of excluding his food allergens from our shared meals. I have had numerous patients who are afraid to eat in the hospital until one of the dietitians visits with them about their food allergies and finds alternative foods they can eat. Often, they voice how much more relaxed they feel about eating at the hospital now that they know which foods are free of their allergens. This helps them focus on the important task of healing.

The next time it feels like a burden to avoid adding peanut butter to your child's lunch or you have to cook for a relative who has a wheat allergy, consider how much more a burden it is for that person to spend their entire life reading labels, avoiding eating at certain places and asking what is in a tasty-looking dish. Consider how lovely it must be for that person to be able to eat what is served because the person cooking has done an excellent job excluding the offending food allergen. Find out for yourself how rewarding it is to see someone with food allergies relax and enjoy eating.

Lynn Eaton R.D., L.D., CDE is a registered dietitian and certified diabetes educator. She works at Capital Region Medical Center as an inpatient and critical care dietitian. She also writes a nutrition blog, which you can follow at

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